MEDICARE: MRS. LISA MERLE HECHT CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	268914L	PA

General Provider Information

NPI Number	:	1265653810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA MERLE HECHT CRNP

Provider Business Mailing Address
First Line	:	538 HAMILTON RD
Second Line	:
City	:	MERION STATION
State	:	PA
Zip	:	19066-1125
Country	:	US
Telephone Number	:	610-667-3212
Fax Number	:

Provider Business Practice Location Address
First Line	:	538 HAMILTON RD
Second Line	:
City	:	MERION STATION
State	:	PA
Zip	:	19066-1125
Country	:	US
Telephone Number	:	610-585-4634
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	11/22/2011

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